TY - JOUR
AU - M. P. Martinez
AU - T. Chow
AU - J. C. Lin
AU - D. Becker
AU - Y. Tsai
AU - B. Velasquez
AU - C. Wong
AU - A. H. Xiang
A1 - 
AB - PURPOSE: Adolescent depression screening in primary care is recommended yet little is known about its implementation and outcomes. We assessed rates of screening, "positive" screening and later diagnosis of depression. METHODS: This retrospective cohort study included 751,876 adolescents aged 11-17.99 years from 1/1/2017-12/31/2021 at a large integrated healthcare system in Southern California with comprehensive electronic medical records (EMR). Screening for depression was implemented at primary care using the abbreviated Patient Health Questionnaire (PHQ). All data were extracted from EMR. Rates of depression screening completion, screening "positive", and subsequent diagnosis of depression were reported overall; by age, gender, race/ethnicity, and estimated household income with Poisson regression comparing rates across subgroups. RESULTS: Among the adolescents, 613,662 (81.6 %) had primary care visits, of these, 403,890 (65.8 %) completed at least one screening during the study period. Although statistically significant, screening rates were generally comparable across age, gender, household income and race/ethnicity. A total of 9.7 % adolescents screened "positive", with some differences within subgroups. Among adolescents with "positive" screening, 30.2 % were diagnosed with depression within two years after the first "positive" screening, with some differences within subgroups. Adolescents self-identified as other gender had substantially higher rate of "positive" screening and diagnosis rate; however, the data was based on a sample size less than 50. CONCLUSION: Depression screening can be administered at primary care for adolescents starting as early as age 11 years old. Screening with PHQ at primary care as part of standard preventive care can effectively identify adolescents at risk for depression.
AD - Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America.; Graduate Medical Education Administration, Kaiser Permanente Southern California, Pasadena, CA, United States of America.; Pediatrics, Kaiser Permanente Southern California, Pasadena, CA, United States of America.; Child and Adolescent Psychiatry, Kaiser Permanente Southern California, Pasadena, CA, United States of America.; Psychiatry, Kaiser Permanente Southern California, Pasadena, CA, United States of America.; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America. Electronic address: anny.h.xiang@kp.org.
AN - 41436008
BT - J Affect Disord
C5 - Healthcare Disparities
DA - Apr 15
DO - 10.1016/j.jad.2025.121017
DP - NLM
ET - 20251221
JF - J Affect Disord
LA - eng
N2 - PURPOSE: Adolescent depression screening in primary care is recommended yet little is known about its implementation and outcomes. We assessed rates of screening, "positive" screening and later diagnosis of depression. METHODS: This retrospective cohort study included 751,876 adolescents aged 11-17.99 years from 1/1/2017-12/31/2021 at a large integrated healthcare system in Southern California with comprehensive electronic medical records (EMR). Screening for depression was implemented at primary care using the abbreviated Patient Health Questionnaire (PHQ). All data were extracted from EMR. Rates of depression screening completion, screening "positive", and subsequent diagnosis of depression were reported overall; by age, gender, race/ethnicity, and estimated household income with Poisson regression comparing rates across subgroups. RESULTS: Among the adolescents, 613,662 (81.6 %) had primary care visits, of these, 403,890 (65.8 %) completed at least one screening during the study period. Although statistically significant, screening rates were generally comparable across age, gender, household income and race/ethnicity. A total of 9.7 % adolescents screened "positive", with some differences within subgroups. Among adolescents with "positive" screening, 30.2 % were diagnosed with depression within two years after the first "positive" screening, with some differences within subgroups. Adolescents self-identified as other gender had substantially higher rate of "positive" screening and diagnosis rate; however, the data was based on a sample size less than 50. CONCLUSION: Depression screening can be administered at primary care for adolescents starting as early as age 11 years old. Screening with PHQ at primary care as part of standard preventive care can effectively identify adolescents at risk for depression.
PY - 2026
SN - 0165-0327
SP - 121017
ST - Depression in adolescence: Screening and diagnosis in primary care in an integrated healthcare system
T1 - Depression in adolescence: Screening and diagnosis in primary care in an integrated healthcare system
T2 - J Affect Disord
TI - Depression in adolescence: Screening and diagnosis in primary care in an integrated healthcare system
U1 - Healthcare Disparities
U3 - 10.1016/j.jad.2025.121017
VL - 399
VO - 0165-0327
Y1 - 2026
ER -